A&G Healthcare Services Announces Post-Adjudication Workflow for TriZetto QicLink Payer Organization
A&G Healthcare Services, a national leader in technology based re-pricing and cost containment solutions, announced it will provide electronic re-pricing services for TriZetto Payer customers utilizing the QicLink system in a post-adjudication model. This new workflow allows for the seamless and automatic repricing of otherwise non-network claims achieving discounts of 20-30% utilizing the nationally known Amera-Net Travel Wrap network and personal negotiation.
Dallas, TX (PRWEB) June 22, 2005 -- A&G Healthcare Services, a national
leader in technology based re-pricing and cost containment solutions, announced
it will provide electronic re-pricing services for TriZetto Payer customers
utilizing the QicLink system in a post-adjudication model. This new workflow
allows for the seamless and automatic repricing of otherwise non-network claims
achieving discounts of 20-30% utilizing the nationally known Amera-Net Travel
Wrap network and personal negotiation.
The process includes a
parameter-driven extract, automatically placing selected non-par claims on hold,
while electronically sending these claims to A&G Healthcare Services for
cost-containment consideration. On the electronic return to the Payer, the
discounted claims are automatically updated, financial accumulators revised, and
the on-hold claim status is removed for completion of the payment process. All
this is done in a matter of hours for 60-80 percent of the submitted claims and
three to five days for negotiated claims under the direction of the Payer
client. All submitted claims can be tracked, reviewed, and reported on by Payer
customers using A&G’s web-based IView system.
A&G Healthcare
Services is pleased to offer installation, implementation, and training of the
post-adjudication workflow at no cost to the QicLink Payer customer, and,
depending on historical volume, is willing to pick up some or all
transaction-based fees as well. From start of implementation to live EDI
transmission can take as little as six (6) weeks to complete.
“The
environment for claims processing and claims re-pricing is changing
dramatically, and payer organizations need the efficiencies produced by our many
services and electronic claims re-pricing,” said Norman Payson, chairman,
founder and CEO of A&G Healthcare Services. “Offering these services in a
post-adjudication workflow environment, guarantees that all claims receive some
consideration for discounting after all other cost-containment strategies have
been exhausted,” Mr. Payson added.
About A&G Healthcare
Services
A&G Healthcare Services, headquartered in Plano, TX, is a
medical cost containment company serving more than 400 Payer organizations by
providing re-pricing and fee negotiation services for claims that have been
determined to be out-of-area or network. A&G also owns and operates a
national travel wrap PPO network named Amera-Net which provides superior
coverage for payer clientele members. Amera-Net is a nationally recognized and
accepted PPO travel wrap network with an established logo for ID cards insuring
proper steerage to providers. A&G’s customers can take advantage of a shared
savings program which can help pay for most or all of the front-end EDI costs.
A&G has served the healthcare payer market for over eight years. For more
information, please call Belinda Kelly at (972) 312-8589 Ext.108 or visit http://www.aghealth123.com.
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Source : http://www.prweb.com/releases/2005/6/prweb253277.htm